Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
IN✓ ' Permit#: ELR2021-00026
COMMUNITY DEVELOPMENT Date Issued: 3/9/2021
T t G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112DA01400
Jurisdiction: Tigard
Site address: 15350 SW SEQUOIA PKWY 198
Project: Spec Space Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: (2)Fire alarm notification devices-relocation
Contractor: POINT MONITOR CORPORATION Owner: PACIFIC REALTY ASSOCIATES
5863 LAKEVIEW BLVD STE 100 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-627-0100 PHONE:
FAX: 503-627-0110
FEES
Description Date Amount
Specifics: Restricted Energy Permit 03/08/2021 $75.00
12%State Surcharge-Electrical 03/08/2021 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 0
Audio&Stereo: 0 Boiler Controls: 0
CCTV: 0 Clock Systems: 0
Data&Telecommunications: 0 Fire Alarm: 1
HVAC: 0 Instrumentation: 0
Intercom/Paging: 0 Landscape/Irrigation: 0
Landscape Lighting: 0 Medical: 0
Nurse Calls: 0 Protective Signal: 0
Security Alarm: 0 Other: 0 Total S84.00
Other Desc: Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
e
Issued By: ��.� y - Permittee Signature: 2 .r^
Q OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application CEIV
City of Tigard a"`�0,37 202/ Permit#: E(,,Q2d2/-POO2tp
• 13125 S W Hall Blvd.,Tigard,OR 97223 r t nn frrl rn� p (1 } Uate73r'
C MNR 4 O 20'i Pate Review
Phone: 503.718.2439 Fax: 503.598.1960 L Ilan Re Related Permit u;Fp,fZQ21'00OZ7
Il Inspection Line: 503.639.4175 ® See Page 2 for
Internet: www.tigard-or.gov CETY'Oh i iiz/,NEJ rodf�e�dioa; rues.
u I, m A m ,. Supplemental information
` ` PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit/sea of plans wrtems checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑Other:
-- -— ---- - - where the available fault current ❑Marinas and boatyards.
r'•7T'7:IS go)`11-1risjsj r (o1.:,;_ ___ __ exceedsl0,000am at150voltsor..-.-. .....—�" Ps0 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
El ❑Master builderamps for au other installations buildings.
❑Other: 0 Fire pomp. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: I Job site address:15350 SW Sequuoia Parkway 0 Addition01IPor more.f new motor toad of system.
—
100HP more. ❑"A "E,•")-2""1_y,•
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#:198 I Project name:PCC241 Spec Suite 198 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 Wu nominal.
Cross street/directions to job site: FEE SCHEDULE `
Description I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
=i, _ .� _ r Ea.add'l 500 sq.ft.or portion 33.92 1
_ ,.i jI Yrv� ?i r! c ,1: v(nU _ . Limited ene
rgy residential 75.00 2
Fire Alarm Notification Devices-relocates only (with above sq.ft.)
Limited energy,multi-family
residential(with above sq.R.) 75.00 2
Renewable Energy 0See Page 2
❑ PROPERTY OWNER 0 TENANT
Services or feeders installation alteration,and/or relocation
Name:PCC241 Spec Suite 198 200 amps or less 100.70 2
Address: 15350 SW Sequuoia Parkway Suite 198 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 55226 2
Email: Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
Branch circuits_new,alteration,or extension,per panel
® APPLICANT 0 CONTACT PERSON
A.Fee for brunch circuits with
Business name:Point Monitor Corp. above service or feeder fee,
each branch circuit 7.42 2
Contact name:Brooke Williams B.Fee for branch circuits without
Address:5863 Lakeview Blvd.Suite 100 service or feeder fee first
branch circuit 56.18 2
City/State/ZIP:Lake Oswego,OR 97035 Each add9 branch circuit 7,42 2
Phone:(503)627-0100 Fax:: Misce1laneous(service or feeder not included)
( ) Each manufactured or modular
Email:bwilliams®pointmonitor.com
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Point Monitor Corp. Sign or outline lighting 67.84 2
Address:5863 Lakeview Blvd.Suite 100 Signal circuit(s)or limited-energy
panel,alteration,or extension. El See Page 2 I 2
City/State/ZIP:Lake Oswego,OR 97035 Each additional Inspection over allowable In any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)627-0100 Fax:( ) Investigation(Ihrmin) 90.00/hr
Email:bwilllams®pointmonitor.com Industrialplaot(Ihrmin) 78.18/hr
Inspections for which no fee is
CCB Lic.: 135901 Electrical Lie.: 34508CLE Suprv.Lic.: 4460LEA specifically listed(Y:hr min) 90.W/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Subtotal:
Print name: Ben Breit Date: 3/5/2021 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: _ J TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Ben Breit Date: 3/5/2021 days atter it has been accepted as complete.
r:euildin PemrirA " Number of inspections allowed per permit.
e Permits ELc_ pp_RLR_ERE.doc Re 06r 2015 400-4615T(11,05,COMWEE
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORC ONLY: FEE SCHEDULE
Ihrviptioe I QV. I Even I Total I •
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 lcva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems In excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7A2 3
❑ Vacuum Systems* >100 ka—no additional charge 0.0 3
Each additional inspection over allowable in an_of the above:
❑ Other. Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 00,hr
'ficall listed h hr min
G(1 RCYA�'4IRd+ ONLY: ,a i (Fatter(Enter%;
Fee for each commercial system: $75.00 Subtotal on Page 1):
• Number of mapections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
U Data Telecommunication Installation
® Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
1.Building Ponnits'.ELC PmnitApp_ELR_ERE.doc Rec 0f.1'2015